The State Health Director has issued a temporary orderrequiring North Carolina physicians to report all influenza-associated deaths in persons 18 years of age or older. Influenza deaths in children less than 18 years of age have been legally reportable since 2004. This order is necessary to enhance influenza surveillance during the current pandemic. For surveillance purposes, an influenza-associated death is defined as a death resulting from a clinically compatible illness that was confirmed to be influenza (either seasonal or pandemic) by an appropriate laboratory or rapid diagnostic test. Physicians should report all influenza-associated deaths to their local health department within 24 hours after death occurs.

Physicians should also be aware that testing of hospitalized patients at the State Laboratory of Public Health (SLPH) will now be available only for those patients who are admitted to the intensive care unit. SLPH will continue to conduct testing for a sample of patients seen by providers in the Sentinel Provider Network and for patients who die with influenza-like illness but have no laboratory confirmation of influenza. Testing at SLPH will also be considered for other situations of public health importance with local health department approval. Testing can be requested through private or hospital-affiliated laboratories if needed for clinical management.

In addition, Dr. Moore, at the request of State Health Director Jeffrey Engel, MD, is asking physicians to read a special email from the CDC asking physicians to be on the lookout for possible “hemorrhagic pneumonia” cases. Read the email at http://www.ncmedsoc.org/.